First Post Op Follow Up Appt

I made a pan of chocolate chip cookie bars to split with the bariatric nurses that took care of me last week and the bariatric office.  My appointment was at 9:15 but Dr G. wasn't in yet -- he was on call for general surgeries and had to do one in Gulf Breeze this morning.

Nurse Jennifer took me back to get my vitals -- my BP was 148/87 or something, which I thought was kind of high, but she said that was normal.

This morning I did weigh myself and it was an even 222 lbs.  Nurse Jennifer weighed me in at 222.8. According to them, my "official" surgery weight was 240.9, so they say I lost 18.1 lbs. since surgery.  But they took that 240.9 weight on 6/11 which was 5 days pre op -- I lost even more weight on my liquid diet after that.

I'm sticking to my HIGH weight of 250.0 and deducting what I get at home, so officially I'm down 27.2 lbs.  What a difference 27 lbs has made.  I am amazed how much better I feel so far, how great my clothes fit, and I think I am sleeping better, but won't know for sure until I get back to work.  I am not getting up at 5 AM while I'm off, so might be tougher next week -- but maybe not!

When I finally got to meet w/Dr. G., he seemed surprised I had lost weight (WTH?).  He said I could start my pureed diet today and I will be on that for three weeks (through July 18th), then I will transition over to Phase 4 -- Soft foods.  He also said I may resume all of my meds and can expect to be on all of them for 6 months post-op, then they will do labs on me to see how my vitamin levels are.  I will also be starting my vitamin regimen.  I need to fill up my pill organizer today so I can start up everything tomorrow.

Dr. G wanted to look at my incisions and he said they looked good.  I told him that there were two that were way more sore than the others and pointed them out to him.  The worst looking one was the one he pulled my resected stomach out of....the 2nd to the worst was the one he had to stretch for his instrument.  Each of the incisions still has the surgical glue on top of it -- I am allowed to peel it off in 10 days if it hasn't already come off, but now that I look at them, they are starting to peel a bit.

I also asked Dr. G about the 2nd hernia he said he fixed -- he mentioned it to me the day after surgery but I didn't catch what kind it was.  It was a diaphragmatic hernia.  Which means that right next to my hiatus I had another very small hole along my diaphragm.  I asked him if there would've been any side effects to having that and he said that organs could have sunk into it or possible pushed through, but there was fat in the hole so it may not have happened.  He closed it up for me.

My next visit it 6 weeks post-op (on 8/6).

So of course I was SUPER excited to be on pureed foods and I went home and made my first pureed meal.  I had a Starkist Creations Tuna packet (Herbs & Garlic flavor), a single dill spear, and a tablespoon of Olive Oil Mayo.  Stuck all of that into my Ninja and WA-LA!  It was sure tasty and different but I barely ate much before I was full.  I am going to finish it off for dinner I think.

I have been doing better getting my fluids down -- I am able to take 3 "gulps" every few minutes or so and that is helping. I make sure to carry water or something with me every where I go so I can keep sipping.

Protein hasn't been great -- I was getting maybe 10-20 grams down a day, but I think Phase 3 will help with that. Oh and I "cheated" a bit last night -- I bought watermelon yesterday thinking I was going to soft foods today and since Rich doesn't eat it, I had a piece.  I took small bites and waited between bites to see how my stomach would do.  I chewed it well and it wasn't a problem.  I am planning to finish what I bought over the weekend and I think it counts a little as fluids too.

I think for breakfast I am going to make eggs and either puree them or just chew chew chew each bite.  I can't wait to find some more recipes -- but I have a feeling I'll be eating a lot of eggs and tuna in the next three weeks.

Ohhh and while I was shopping at Publix yesterday, I just happened to notice a thermos on their shelves that I have on my Amazon wish list.  It is sooooooo super darn cute and will be perfect to throw my oatmeal/cream of wheat/eggs into when I return to work.

Wow, wow...

So as of this morning I am down a total of 26.4 pounds from my high weight of 250 in April 2014: 223.6 lbs.  Down 11.6 since my surgery on Monday, 6/16!

Spontaneously, I just HAD to try on the many pairs of jeans I've had sitting in my closet for a while.  Keep in mind I have been wearing ONE pair of jeans (size 16 from Lane B) that fit me at 250 but barely.  I am sure I was really an 18 but wouldn't buy a size 18.

So I have a lot of "true" 16s that were retired long ago when I started gaining more weight.  I am so pleased that ALL of them now fit me just fine (at least 4-5 pairs) and even one size 14 (Lane B) fits me too!

I gotta tell you it is really nice to see the scale go down EVERY DAY since surgery, but I know that a stall is typical 2-4 weeks out.  This is because my body is getting used to my new weight.  Also I hear when you're not losing on the scale, you are probably losing inches!

I forgot to mention in earlier posts that my doctor fixed my hiatal hernia while we was operating on me AND a 2nd hernia (forgot the name) as well -- which is awesome!

Instead of trying to think of ways to keep myself entertained the next two weeks, I'm going to concentrate on getting my 60 oz of fluids in and getting 2-3 walks in every day as well as 3-5 meals.  I cannot let myself get dehydrated....dangerous, dangerous!

So back to my weight.  It is sure nice to be back in the 220s (and so quickly!) but the real joy will be in getting under 200 since that is pretty much my lowest adult weight I achieved on my own.

I also meant to mention that my skin has never looked so good -- my face in particular.  I haven't had any breakouts since a week before surgery AND my psoriasis seems to be improving as well.

That is all for now!

Wow.

So it is post op Day 6 and I am already down a total of 20 pounds from my highest weight during my 6 month pre-op supervised diet.  If I'm just counting the pounds lost from my surgery date, I'm down FIVE, but I also weighed 235 before surgery and 244 after, so technically I re-lost 9 pounds (of fluids) this week plus an extra 5.  However you see it, I personally see the number on the scale: 230.2 and am amazed.

Last night I suggested we go out to eat -- somewhere that has soups I can eat.  So we hit Ichiban and I got egg drop soup.  I barely ate much before I was full but it was damn good!  A nice change to eating at home every meal when I was so used to eating out all the time.  So it was a treat, for sure and as Rich called me, "a cheap date" since my meal was only $3.50.

I forgot to go on a real walk or two yesterday, so I am going to make it up today.  I woke up early this morning with a mild headache that I couldn't shake, so I got up and took a half dose of my liquid Lortab and eventually it dissipated and I slept.  I woke up with the same headache, though, but my abdomen feels even better than yesterday.  I am going to get some water in and see if that helps my headache -- I can't imagine that I'm dehydrated as I've been doing well on getting fluids in.

Four Days Post Op

Yes, I'm alive.  I didn't feel much like updating my blog this week.  

Monday morning we got to the hospital so early.  I had my bag of essentials and my pillows from home.  As soon as I got my hospital band they did another EKG on me, then back to the waiting room.  They they took me up to a room where I got into a gown and waited until after 8 AM before they brought me to the surgery room.  Once I got on the surgery table they put me under pretty fast because I don't remember a thing until I woke up in my private room.

I think I first remember Jim & Joyce in my room talking to Rich about something and I was disagreeing in my head with some detail Rich was talking about but I couldn't speak or open my eyes.  I was still VERY out of it, but somehow conscious?  It was surreal.

I heard Rich say, "Open your eyes, Jame." and I remember trying very hard to open my eyes but they were so, so heavy.  I kept thinking why won't my eyes open?  Gosh I'm so tired, I really want to sleep.    

Eventually I did open my eyes and said hello to Jim & Joyce and Rich.  Alisha stopped by later but honestly I can't remember much about the day of surgery afterwards.

Throughout the day and night I kept having my vitals taken, and at 3:15 AM Tuesday morning I had blood taken for labs (also on Wednesday morning).  I asked for pain meds on Tuesday sometime because I had severe back pain and my belly hurt pretty bad -- more soreness than anything but SO uncomfortable.  They put morphine in my IV.  Boy, that felt really weird.  And good.  And instantly took my pain away.  I could feel it coursing through my veins, my fingertips and down to my toes.  How weird!  I felt great.

I got up and walked as often as I could, knowing it would make me feel better.  I'm not sure how much gas I had to expel in my belly -- I wasn't passing gas at all but I was burping a lot.  

I craved crushed ice, so my nurses kept me stocked.  On Tuesday morning I did go down for an upper GI to ensure I had no leaks in my new sleeved stomach -- I passed and they let me know that right away.  So that meant that lunch I got broth and tea and pudding I think.  They kept bringing me yellow jello which is nasty.  I liked the cream of wheat -- added a little butter and sugar substitute and that made it palatable.  

Wednesday morning, Dr. G. came to see me and picked up  my sheets of paper where I'm supposed to track my walks, my spirometer usage, and my fluid intake, but I hadn't filled out much because I really didn't know that was my job.  Four ounces of fluid every waking hour?  Yeah, I don't remember those instructions, so he wasn't happy with me.  He said he wanted to see three straight hours of doing everything I'm supposed to be doing and then he'd discharge me.  I never saw him again though -- the discharge nurse came in around 2 PM and Willie gave me a ride down to the entrance so Rich could take me home.

Thursday at 3 PM I got to take a shower finally -- boy that felt GREAT!  My hair was rank.

So the last couple of days I've been sleeping, eating, watching TV a lot, napping, drinking water, and taking walks around the house since it is so hot outside.  I did go for a 10 minute neighborhood walk this morning but it was really too hot outside.

I weighed as soon as I got home on Wednesday and I was 244 or so -- the result of LOTS of fluids being pumped into me 24/7.  Today I'm around 237 which is just a couple pounds higher than my Monday morning pre-surgery weight.  

My stomach is super sore and alien looking.  I have 5 holes and one drain hole -- they all have some kind of skin superglue on them that will eventually wear off.  I guess due to swelling, my belly is super bumpy -- strangely so!   

Rich is taking good care of me.  I am so glad he was able to be with me all week.  I am already getting stir crazy in the house, so I have to figure out how to entertain myself for the next two weeks before I get back to work.  I have a list of stuff I can work on.  I guess I have to use this time to heal as a priority, but I feel so unproductive!  Looking forward to the weekend - maybe we can go somewhere besides home.

Day Before Surgery

Grape magnesium citrate is VERY sweet! I had a hard time drinking it yesterday just because of that alone. My palette is so used to bland, sugar free, water, etc. that even Powerade Zero is a shock to my mouth.

I feel empty. Literally. I didn't feel much hunger yesterday, surprisingly.

What has gotten me through these 14 days? Knowing that it will help me be more successful after surgery. Knowing it will make my surgery easier for my doctor. Knowing if I complete the 14 days successfully, that there is a high chance of success afterwards. I took it day by day, trying not to dwell on how many days I had left.  It helped a lot to have a supportive husband that talked me out of cheating...although I'm really not sure if I would've followed through.  I'm down 13.4 lbs., so seeing the scale go down almost every day was also very motivating.

Rich took me to a book store and I got James Patterson's Mistress and a book called Shoe Lovers Anonymous which looks like it's right up my alley!  I'm hoping I will feel up to reading in the hospital.  If not, I guess I have three weeks to get through them.

I don't have much energy at all but I'm going to try and make one card today and do my "before pictures" scrap booking page.

Tonight before I go to bed, I'll be drinking two bottles of water and taking what they call a "surgery shower".

Since we have to be at the hospital at 5:30 a.m., I will be getting up around 4 to leave by 5. Glad it is early because nothing should delay my doctor AND I won't be awake very long to think.

Day 12 Pre-Op Liquid Diet

Last day for protein shakes.  :(

Tomorrow and Sunday I will be prepping my bowels!  Yippee.  That means I have to drink a bottle of magnesium citrate before 2 PM tomorrow.  My diet for the weekend consists of cranberry grape juice, sugar free popsicles, sugar free jello gelatin, G2 Gatorade, Powerade Zero, beef broth and OH, don't forget H2O.

The protein shakes have really been sustaining me and keeping me full enough not to turn into a complete bitch.  So this weekend will be challenging.  I hope my husband is prepared. LOL

As of this morning; however, I am down 11.4 lbs!  And BOY do I feel it.  My go to jeans felt great today.

So I have to ramble a bit about my recent thoughts.  Right now at this very moment, I am craving food, of course, but not just any food.  I am craving healthy foods!  It's already like my brain is saying, "ok, fine, I guess we're going to do this healthy thing!"  I daydream about fresh salmon and green beans, edamame, asparagus, shrimp, salad...you name it.

Sure, I am also thinking about Waffle Chicken Fingers from Popeye's (limited time only, people!) and General Tso's chicken, Publix subs, pizza, and Reese's cups.  

But you know what?  This whole 12 days that I have been essentially food-less has given me a new appreciation for food. Seriously!  I imagine my self truly savoring each bite and letting the smell of food touch my senses in a new way.  Good thing, too, because I'll probably only be able to have 3-4 bites of food at a time when I start having a regular diet in mid-August or so.

I will admit I did cheat while on my liquid diet.  Four days ago or so, I had an M&M.  Yup, just one.  And I let it sit on my tongue, rolled it around a bit, and eventually it melted.  I savored and appreciated that M&M.

Today I sucked on a french fry at work -- just to get the flavoring on my tongue.  I just wanted to have a different taste in my mouth.  

I stop at doing anything "worse", for example, a #1 Big Mac meal at McDonald's with a chocolate shake (large combo, of course) -- because I know after this long time on a liquid diet, eating that way would make me very, very sick.  And I know it wouldn't be worth it.  And I'd be mad at myself.  

So I've made it this far -- what's two more days?  I can do this.

Final Pre-Op Appointments

Today I had my last two pre-op appointments -- the first one was with Nurse Lynell.  She asked me about all my medications, instructed me about the two antibacterial showers I would need to take (one the night before surgery and the 2nd the morning of).  She gave me a bottle of Hibiclens and I have to shower regularly then put half the bottle all over my body except my girly parts and my face, then let it sit for 2 minutes and pat dry.  Cuts down on infections apparently.  Yay for that.

I also had some labs done by a lady that a few minutes before she stuck me with a needle, said, "I hate my job" to another coworker passing in the hall.  Nice!

My second appointment was at the bariatric clinic -- I weighed in with Jennifer.  My "official" pre-surgery weight is 240.9 lbs; however, my high weight during the last 6 months was 250.  It's bugging me that I don't know the exact number (250.?).

I'm thinking about the general stats for gastric sleeves -- I'm expected to lose 50-70% of my excess weight.  If I am supposed to be around 155, that means that I can expect to lose 43-60 lbs or get down to 197-181 lbs.  That's fine and dandy, but I don't want to be 197 lbs.  Or 181 lbs.  I want to be between 155-165 tops.  I think that's a healthy weight and I plan on doing my damnedest to get down to where I want to be in the next 18 months.

After I saw Nurse Jennifer, I met with Dr. Gatmaitan.  He gave me a 6 page consent form I had to read over and sign.  Three of those pages were a list of all of the side effects and complications I could have from surgery.  Yeah.  There were a TON.  Makes me think a bit.  I usually have the mindset about things that "Oh, that'll never happen to me!" -- it's how I feel about major complications, getting cancer, dying young...but you never know, I guess.

So that's that.

Days 5-8 - Pre-Op Liquid Diet

Much of the same!  Weekend was difficult for me because we used to eat out at least 4 meals on weekends.  I feel like I'm mourning at this point.  I have been brought to tears a couple times because I couldn't eat what I wanted.

But I got through the weekend just fine.  And this morning I am down a total of 9.4 lbs.  It's amazing what 10-ish pounds difference can make.  Ten-ish pounds ago my ONLY jeans I can wear comfortably (size 16) were getting tighter by the day.  My wedding ring didn't fit.

Ten-ish pounds down and the jeans fit OK again.  I can wear my wedding ring again.  :)

Then I think....this is just the beginning, Jamie...next thing you know it, I'll be slipping on my special size 12 dress I bought for New Year's Eve...only time will tell.

Friday last week Rich accompanied me to my pre-op education class.  It was interesting!  The only things that freaked me out a bit were hearing about my catheter and drain.  I was also pleasantly surprised that I could have NSAIDS after surgery because I'm getting the sleeve.  That'll be nice to pop an an Advil when I need it, knowing it'll work.

My last pre-op appointments will be Wednesday this week.  At 12 I'll meet with a nurse and my anesthesiologist.  We'll go over my medical history then.

At 1 PM I'll meet with Dr. Gatmaitan for final instructions before surgery and to sign the consent for surgery.

So, six more days to go.  

Day 4 - Pre-Op Liquid Diet

Today was GREAT!

Had my typical breakfast and lunch, but I changed up dinner a bit.  Since the Herb Ox granulated bullion packets were so bland, I added one instead to my UNJURY chicken soup flavored protein shake.  YUM!

This morning I weighed in at 242.2 -- down 6.6 lbs. since Monday morning.  Wow!

Tonight I made 80 cookies -- half for the bariatric office and half for my work peeps.  It was hard not to eat one out of the oven -- I thought about it!

Besides that, this was another temptation I faced today -- my favorite...

But I resisted all the temptations today!  Success!  I can do this!

Day 3 - Pre-Op Liquid Diet

Ugh.

Today sucked.  I got to bed early last night and thought I slept well, too.  But I just couldn't get out of bed...well I did eventually, but for some reason it was so much harder today.

Made my breakfast shake -- it was vanilla UNJURY with raspberry sugar free gelatin and raspberry SF Torani syrup.  It tasted Ok but the texture was horrible.  I don't think the gelatin dissolved properly?  Regardless, I finished it.

I left work to go see my primary care physician, Dr. Nichols.  He reviewed my blood test results and said that my cholesterol was still good but it was better last time.  He mentioned increasing the dosage on my cholesterol med and that's when I revealed that I had surgery coming up.

That changed his recommendation.  He wished me good luck and said that he couldn't wait to see me in 6 months.  I said, "me too!"

After my appointment I sat in my car for a few minutes and really thought I could just lean back and fall asleep.  I was feeling very weak and overwhelmed with fatigue.  I read on different boards more than once that "day 3" was the worst for a lot of people.  Not sure why -- I'm sure it's a physiological reason of some sort.  All I know is that I just wanted to sleep - desperately.

So I got the OK from my boss to take the rest of the day off and I went straight home and slept for 5 hours.  I feel a bit better now that I have some UNJURY chicken soup in me, plus a 20 oz Powerade Zero and a bottle of water.

This morning I weighed in at 244.0 so I'm officially down 4.8 lbs.  At this rate I'll be down 20 lbs by June 16th!  Yeah right!

So I'm pretty sleepy and think I'm just going to call it a night.  Hoping day 4 will be better.

Day 2 - Pre-Op Liquid Diet

Today went well.  I wasn't as hungry as I thought I'd be!

This morning I weighed in at 246.2 -- down 2.6 lbs!  It's nice to go in the OTHER direction on the scale for once.

For breakfast I had Advocare's Chocolate Meal Replacement Shake which had 24 grams of protein.  I mixed it with skim milk and it was pretty darn good -- no Torani syrup this time, but I did add an ice cube.

Started to get a bit hungry around 10 AM so I made a cup of tea -- Tazo's Passion, with two Truvia sweeteners.  DELISH!

For lunch I made UNJURY Chocolate Splendor shake -- straight up (which means w/skim milk only).  It was pretty good, but when I use my Blender Bottles, I don't get NEAR the volume as I do with my Ninja.

Around 2 PM I drank most of a 32 oz Powerade Zero - Mixed Berry flavor and I had a snack cup of the cherry Jell-O.

Dinner was a freaking science experiment -- unexpectedly!  I decided to try the beef buillon powder in hot water.  The instructions say to heat up 8 oz of water to a boil, so I put a cup of water in my Pyrex and miked it until I saw the boil.  Then I added the powered and BOOM it bubbled up suddenly up over the rim!  I was so startled that I lost some of my powder on the oven top.

It tasted verrrrry bland (read: SODIUM FREE).  I like sodium though, so I added a bit of salt to liven it up a bit.  I finished it but I prefer the UNJURY Chicken Soup for flavor.  I also bought the chicken version, so I will give it a try, but I'm tempted to use two packets per 8 oz of water to strengthen the taste.

For dessert I had an orange sugar-free popsicle.  It was fun to eat because I could suck out the juice.

I have found it helpful to brush my teeth after dinner so I feel "done" with eating for the day.

I'll tell ya one thing, I have to pee every hour or so -- but it helps me at work to get up and walk even for a minute.

Taking this a day at a time - I know I can get through 12 more days.

Day 1 - Pre-Op Liquid Diet + Measurements #2

Today is my 37th birthday.  It is also a sort of "re-birth" as today was the first day of my pre-op liquid diet that I will be on for 14 days leading to my surgery.

To mark this date appropriately, Rich helped me take my measurements again.  Interestingly enough, I gained in some areas, stayed the same in others.  I cannot believe my calves are 20" now.  I need to lose at least 6 inches to be able to get some hot boots.  I digress!

I AM APPROVED!

Today at 11:11 AM I missed a call from Nurse Jennifer.  Her voice mail made my day.

"Hey Jamie, it's Jennifer at the bariatric center.  I was calling to see when you want to get your surgery scheduled. I got the approval, so call me back!"

Music to my ears.

I gave her a call back and my surgery is set for Monday, 16 June at 7:30 AM.

So.

Happy.

I have to attend a pre-op appointment on 6 June for two hours.  I think this is the part where they go over everything to expect before/during/after surgery and to provide an opportunity to ask more questions?  We shall see!

The morning of my surgery I have to be there at 5:30 AM.  I'm not going to be able to sleep that night anyway, so that probably won't be an issue getting up at 4 AM to wash my hair and straight iron it (heh heh).  Besides, I will probably be sleeping most of that day anyhow!  If I'm not taking a walk up and down the hallway or to the restroom, I plan on catching up on my beauty sleep!

So I owe Amber some of my chocolate chip toffee cookies.  I will bring them for her on the 6th.  Small price to pay to expedite my paperwork.  I can't believe it only took 5 business days (Monday holiday doesn't count!).  I don't know what I was worried about -- thinking I'd be denied and have to make an appeal -- I did everything by the book though!

I start my liquid diet on June 2.  I really don't think I'm going to have any problem complying.  Honestly, I've had enough "last" meals the last few months.  I am ready to do whatever it takes to be SUCCESSFUL.

Oh, I forgot.  While I was at work today I instant messaged my brother and let him know the news.  He asked me if I had heard of some guy on MasterChef that had lost 155 lbs. since the show last year.  Apparently he was 400 lbs. and shocked viewers by his weight loss.  He had a sleeve gastrectomy.  He sent me an article about it which led me to a doctor's blog about WLS.  Thought I'd share a link to a very interesting article about how weight loss surgery resets the bodyweight set-point.

Waiting Game

Today marks one week since my paperwork was sent to Carefirst for review and approval.  I hadn't heard anything all week, so just because, I decided to call Carefirst myself.

I thought it would make me feel better to hear that they had received the paperwork at the very least.  I spoke to Shanika, gave her my ID, confirmed my birthdate and gave her my call back number.  She brought up my record of sorts and told me that nothing had been received.  I asked her if a week's time was sufficient to show up to where she could see the request and she said it was and that it normally shows in 24-48 hours.  So I politely thanked her and wished her a nice weekend and disconnected.

Then I furiously dialed the number for the bariatric office and chose the option to speak to the insurance specialist, Amber.  She did not answer so I left her a desperate email telling her what I had found and asked her to check into it and call me back.

Next I stewed in my chair.

Then I pulled out my medical card and flipped it over to study the numbers more closely.  Hmm.  There was a separate phone number for "Inpatient Pre-Certification".  Well THAT sounded more promising.  And I'm just the kind of person that has to be told TWICE before I believe something like my fax never arrived.

So I dialed.  I hit the option that led me to "my nurse"....A lady answered, I gave her my ID, confirmed my birthdate and gave her my call back number.  I asked her if she showed any documents received for me and she paused...typed...paused...then she said.... wait for it... wait for it....

"Is this in regards to your June 16th surgery?"  I was like OMG OMG OMG OMG (inside).  Then I was cool, calm, collected...and responded, "Yes, yes it is."....then she said...."well....TENTATIVE date for June 16th".....  :D

She said it had been received on Friday of last week and that it was still under review.  I asked if it would be OK to call back next week for a status update (as if I need permission -- HA!) and she said, "Oh yes, that will be fine -- in fact, take down this reference number and provide it when you call back so that they can find your case faster."  (Inside I said "I LOVE YOU NURSE LADY")

So I am pretty excited about having a TENTATIVE date.  I am really hoping I'll hear about approval next week.

After I got off the phone with nice Nurse Lady, I immediately called back the bariatric office insurance lady and said "oops never mind, they got it!  LOL.

Next, I looked up at my calendar and started doing calendar math in my head.  Let's see....Monday, June 16th minus 14 days on a pre-op liquid diet brings me to.......to......to.....

Um.

June 2nd.

My 37th birthday.

Which means.  I have.  Basically.  ONE WEEK.  To eat my heart out! OMG OMG OMG

Ok I actually don't mind that I'm down to one week (technically 9 days).  I have kind of over done it for the last 6 months with eating my heart out.  I am ready for the change honestly, but I will still allow myself one or two (or three) "last meals"....Rich and I already made reservations at Melting Pot for Sunday night (All You Can Eat Fondue, no less).  I may have to get some McDonald's fries (super damn fresh, of course -- otherwise, they're not worth eating).  Hmm what else.  I may need to have a slice from Sky's Pizza Pie.  That should do it.  Oh and maybe a large sweet tea from Chick-Fil-A or McD's.  That'll do.  Wait, I forgot about Reese's Cups.  And pop secret popcorn with peanut M&Ms.

So that was my excitement for today!  Yay!!!

JUNE 16TH!!!!!!!!!!!!!!!!
(maybe!)  

Nutrition One-Hour Wrap-Up

Friday morning was my one hour wrap up with Ashton.  I weighed in beforehand at 249.0.  Half a pound less than the day before.

Ashton went over in more detail each phase of my eating plan before and after surgery.  Here they are in a nutshell:

Phase 1
This comprises my pre-op diet which could be up to 14 days before surgery.  I can only have clear liquids plus protein shakes.  Clear liquids include sugar-free jell-o pudding, sugar-free popsicles, broth, crystal light, Powerade Zero.  The protein shakes are what's going to keep me full and the popsicles and pudding is what'll keep me sane LOL.

Day of Surgery
= NPO.  NPO means "nothing by mouth"...no ice chips, no gum, no NOTHING.

Post Op Day 1 is also NPO until I have my UGI which is a procedure that checks for leaks -- I believe it is the same procedure I had a little while ago when I drank some barium mixture so they can take pictures of my stomach.  As long as this is clear, then I can have clear liquid after.

Post Op Day 2 is when I begin Phase 2.  Phase 2 lasts up to 10 days until I follow up for the first time with my surgeon, Dr. G.  When I'm on Phase 2, I'm supposed to "eat" 3-5 times a day with at least two of those meals being "food" meals vs. protein shakes.  On this phase I can have watered down juices, broths, cream of wheat when cooked with lots of water or milk, milk, yogurt, and protein shakes.  I have to try to get in 80 grams of protein a day.

Phase 3 - Puree Diet
Well this should be interesting.  I'll be on the puree phase for days 10-30, approximately.  Ashton suggested mixing tuna with a bit of olive oil mayo in my Magic Bullet as a meal.  I'll only be eating 1-2 ounces at a time for each meal and my meals should last 20-30 minutes each with about 5 minutes in between each bite.  I can have all the stuff from Phases 1 and 2 plus pureed cooked eggs, high protein meats (pureed in the bullet!), smooth peanut butter (yay!!!!!), cereals like cream of wheat, melted cheese (double yay!), fat free cottage cheese, skim milk, mashed potatoes, pureed/mashed green beans, canned fruits (awesome), baby foods (NOT).  Things I can have but in moderation (once a day I think) are sf pudding, sf gelatin, low sugar or sugar free ice cream or yogurt, salt, mayo, butter, sour cream, herbs & spices.  This will be a fun phase I think!

Phase 4 - Soft Diet
I'll transition into Phase 4 at about the 30 day mark and be on it for approximately 4 weeks.  At week 6 post-op I'll meet with my surgeon again for follow up.  Again I'll be eating 3-5 times a day but only about 1-2 ounces per meal.  This phase basically includes any non-irritating low residue foods.  Everything I eat has to be thoroughly chewed to avoid obstructions or blockage.  I can only add in one new food to each meal so if I have an adverse reaction I will know what did it.  Protein will be the "star" of each meal and what I eat FIRST.  The foods I'll be allowed will include everything from Phases 1-3 plus low fiber cereals such as cheerios, rice krispies, or special K.  At this stage I won't have to puree anything but I just have to chew, chew, chew!  I have a feeling I will be eating a lot of eggs, cheese, yogurt, peanut butter, and chicken here.  I am going to change things up though and make some flakey fish here and there and have thin deli meats for lunches.

Phase 5 - Regular Diet
This will start at around Week 8 which will be mid- to late-August I think.  Initially, I can have all foods except those that cannot be thoroughly chewed or which cause discomfort or irritation.  I have to avoid bread, rice and pasta for SIX MONTHS after surgery and avoid solid red meat until I get my surgeon's OK.  I am supposed to have 2 cups of milk or yogurt daily and a protein supplement that provides at least 20 grams of protein.  A sample breakfast is 2 tbsp of eggs and 2 tbsp of oatmeal.  A snack would be 1 oz of cheese and 1-2 slices of apple or 1 ounce of chicken salad and a couple of whole grain crackers.  It's hard to believe that will fill me up, but I bet you it will!

Eventually on Phase 5 over time I'll be able to eat slightly more at each meal.  When this happens, my regular diet will consist of three small meals per day limited in volume to 3-4 ounces per meal.  I have to remember to listen to my body and stop at the first signs of fullness.  I have read on my Facebook groups that some people's first "signs" are hiccups, burping, or just an uncomfortable sensation.  That's why you have to space out your bites of food and take your time so that you don't eat too much and your body has time to TELL you it's full.  A typical breakfast for me on this second part of the Phase 5 diet would be 2 oz of high protein greek yogurt and 2 oz of Kashi Go Lean cereal. A snack might be a slice of cheese if I really felt I needed something between meals or there is a long time between meals, but I have to limit my snacks to 1-2 ounces.

So that's about it for my wrap up appointment.  Afterwards I went back to the front desk for Ashton and I to talk to Amber the insurance girl.  Ashton asked if they could submit to my insurance without cardiac clearance and Amber said they could, yes, since it isn't the insurance that requires the cardiac clearance, it's my doc, so we can get that later if need be.  While we were standing there, Nurse Jenn comes out and says she just got a call from the cardiac office and they said they didn't receive the results yet.

I decided to go up there to see what could be done to expedite things.  I was firm but nice and they told me that most likely my results were in "transcription" which is where they go to be written up for the doctor to interpret.  Ashton assured me when I went back down to report on my findings that she would keep on top of things.  When we asked Amber about submitting that day I told her there would be cupcakes in it for her...then Ashton mentioned to Amber that I was the "cookie lady" and Amber's whole face lit up!  She said she LOVED my cookies and she'd rather have those than cupcakes any day.  I told her you got it!  So I have some baking to do before my next appointment LOL.

This afternoon as I was reviewing the eating plan for this blog, I came across Amber's email address, so I sent an email to her and to Ashton asking if they were able to submit Friday.

Oh and I also got my lab work results -- I was deficient in Vitamins A and D, but being on the multi should take care of those levels.

This week is clear as far as appointments go, Thank God.  I am tired of driving around places after work, even though it is for this.

Ashton mentioned that once I get insurance approval, Jenn will call me to schedule the surgery AND my pre-op class which (again) goes over Phase 1 pre-op diet and other things.  I thought I remember her saying I'd have to have more labs before surgery too, but I honestly can't remember now.

What a whirlwind it has been and my poor leave balances at work have taken a beating.  I will be working the next few holidays to bank hours for my surgery so that I can be paid 100% of what I am used to getting.  And to ensure I have enough leave for our trip to Ireland in September.

One additional thought.  My husband and I often entertain ourselves by eating out or ordering in.  Once I have surgery, I have a feeling that eating out (in Phase 5 +) will be frustrating and a waste of money, which will totally take the fun out of it.  I hope that we can come up with new (more active) ways of spending time together like working out or taking more drives to the beach with our pups.

I am nervous about Ireland and what I'll be eating there.  I have a feeling I will be taking a bunch of protein powder with me to ensure I get 80 grams in.  At least I'll be thinner by then and feeling better.

So now that I don't have any more appointments scheduled (although I do have a PCP appt 6/4), it is now just a waiting game until insurance approval.

I have a guess as to my surgery date:  the 17th.  It's my lucky number.

Nutritionist Consult #6

Weighed in at 249.5 so lost a half pound since last month.  Then met with Ashton.  It seemed like a formality.  We didn't set any more "goals" for next month.  It was maybe a 10 minute meeting.

Here's my $35 copay, please weigh me.  Okay, okay, I know it's necessary for insurance approval.  Besides, tomorrow is my one hour meeting with Ashton to go over the whole eating plan before and after surgery -- all of the phases.

She did have my chart and she asked me when I did my labs -- I told her it was in February.  Apparently it is not uncommon that the lab people forget to send them to the bariatric office.  Plus I technically do not have cardiac clearance yet -- waiting on Dr. Langhorne to review my stress test pictures.  Ashton said she would follow up on both tomorrow.

So once she's got what she needs, she submits usually same day to insurance.  Amber, the "insurance chick" that works there said that for Carefirst Administrators, their response time "depends on how busy they are"....I asked if it helped at all if I called every day and she said no.  LOL, I tried.

Ashton did ask me if I had a date in mind for the surgery (because of work) and I said as soon as possible, but it would be nice to have it on my birthday, June 2nd.  I have also had the 17th in mind because it is my lucky number.

Honestly I told her that any date in June would make me happy, and she said she thought that would be possible as they are not scheduling very far out, meaning, they are not booked up the next couple months or anything.

So it was pretty short and sweet.  I still can't believe how fast time has flown.  I still have worries that insurance will deny me and my doc will have to appeal for me and I won't have surgery until long after June.

The journey thus far has had some bumps but I think it has been pretty darn smooth.  I sure am hoping everything works out the way I have it planned in my head.

Support Group

Rich and I attended support group tonight.  There was no special guest -- it was the nutritionist Ashton and nurse Jennifer and Dr. G (nice surprise!).

Other than Lori, there were no familiar faces from last month, including the new friend I made last month that had the sleeve - Leticia.

One new thing I learned was that those who have an issue with depression pre-surgery will have a greater likelihood of having increased depression symptom post-surgery.  One of the reasons is that the patient still sees their old (fat) self even after they've lost the weight.

I have never had a problem with depression.  Sure, I've been depressed about my weight from time to time, I've been depressed because I haven't seen my family in a while and am sad.  I may wake up in a bad mood and seem depressed all day.  But being depressed (at least to me) is different from "having depression" -- at least in the clinical sense that one is diagnosed.

See, I can't even IMAGINE that I would see my old fat self after losing weight.  Sure, I may think, "oh, I hope I can lose 15 more pounds - that would be great!".  

But I have lost weight before and I distinctly remember feeling AMAZING, CONFIDENT, SEXY, loving the attention.  It was mentioned by the doctor tonight that some people can't handle the new attention or the way people now look at them after they've lost weight.  

I sincerely hope that I am not like that.  After years and years of feeling overlooked by others because of my weight -- strangers and non-strangers alike, I would welcome the compliments.

HOWEVER.

I know I am going to be one of those people that will be very annoyed, disappointed, and/or angry because of the attention/comments/compliments/acknowledgement/etc. that I receive once I'm at a healthy weight that DIDN'T give me the time of day when I was heavier.  

So if you're going to be one of those people that says hello (and you never did before) or ask me to hang out or go for drinks (when you didn't before), or if you're going to be jealous of my success or my smaller-size-than-you jeans I rock out, please just keep it to yourself and ignore me like you did before.  My weight doesn't define me, my character does, among other important traits.  And honestly if you are one that treats ANYONE differently based on their weight (or sexual orientation, or race, or gender, or nationality, etc etc etc), then you are probably not someone I want to have in my life anyway.  :)

Ok, that is all.

Echocardiogram & Stress Test

Tuesday this week I had to get to the hospital at 8 AM for my stress test.  Once I got back there, they started an IV so that they could administer some kind of radioactive fluid that is needed to take good pictures of my heart.  I had to wait 45 minutes for the fluid to get through my body, so they went ahead and did my echo to take advantage of the downtime.

The echo chick was nice.  I had to put on a gown so that she would have access to the left side of my chest.  All she did was do a sonogram of my heart from a ton of angles.  She took about 25 minutes or so to finish.  Wasn't so bad!

Once I wiped off all the gel and got dressed, it was time for my pre-stress test photos.  I laid down on this very thin (8 inches wide) strip of metal with a pillow under my knees for comfort.  The nurse told me to put my left arm above my head and then gave me a rope to hold on to.  My right arm had the IV still in it and although it was "flexible", it was painfully uncomfortable to bend my arm and they wouldn't let me hold my arm across my waist anyway, so I had to tuck a few fingers under my butt to keep my arm still.

The photo taking machine was very close to my chest and it rotated around from left to right, stopping about a dozen times to take photos from all kinds of angles.  The whole process of pre-stress test pix took 10 minutes.

When it was done, I could move my arms and my poor right hand was completely numb.  The nurse helped me up and took me to the treadmill room.

I met two ladies -- one was in charge of the machine that controls the treadmill and also monitors my heart rate and blood pressure.  The second lady was there to watch me on the treadmill and once my heart rate got to 85% of max (which was about 156 bpm), she was to inject me with more radioactive fluid.

The treadmill started at an incline at at around 2.5 mph.  Within a couple minutes my heart rate jumped from the 90s to the 120s.  I was thinking based on that quick increase, this would be a piece of cake.

Boy was I wrong.

I hovered in the 120s for so long that they decided to bump it up -- the incline AND the speed...to 3 mph.  Eventually my heart rate went up to the upper 140s.  After another minute or two they bumped up the speed to 3.5 mph and I felt like I was at my max.  They asked me if I was OK, do I feel lightheaded, etc...and I responded, "Just trying to breathe!!"...

I couldn't walk at 3.5 mph (had to go into a jog), so they decreased it to 3.0 and I was so close to 156 bpm that they went ahead and stopped the treadmill and injected the fluid into my IV.

Then they made me sit in a chair for 10 minutes to get my heart rate down back down under 100.

After that, I was taken back to the thin metal bed and did those pictures for a 2nd time.  The goal is that both pictures "match".

Once they released me I headed home and took a 3 hour nap.  Oh by the way, I was on the treadmill for a total of 7 minutes and 6 seconds.  I am so out of shape.  In my defense, though, they didn't let me warm up or cool down, which I would've done to increase my endurance in a normal treadmill workout....and eventually build up the incline, but really they just threw me into it to make my heart beat faster quickly.

Friday morning I got a call from that office from Ann.  She informed me that I had PASSED my echo, that it was NORMAL.  She said she did not have my stress test results as Dr. Langhorne was not in the office today, but I would get them some time next week hopefully.

Next week is the BIG week.  MY big week.  Last NUT appointment, final write up....I also have support group, have to get some blood drawn for my 6 month PCP appointment.  Just LOTS to do.

Ann seemed confident that my stress test results would be fine based on my good echo.  We shall see. I am crossing my fingers.

Vitamins

So I got my first box of vitamins and Nascobal from the Q Pharmacy folks that had a rep at my first support group meeting last month.  It was a nice surprise to also get an iron supplement because they mentioned at support group that you'd need to pick that up separately since their multi did not have iron in it.  For $25 per month, you really can't find a better deal around.

I ordered a very cool vitamin/pill organizer off of Amazon and filled it up for the week and officially started them all yesterday.  I ended up ordering a 2nd container so that I only have to prep them twice a month.

I've only been taking all of them for barely two days but it'll be interesting to see if I feel any better, have more energy, etc. after I'm on them a while.

So here's a picture of what I'm all taking as far as vites.  I added the Biotin in since I already purchased a couple bottles.  It promotes new hair growth, nail growth, etc....but I've heard it promotes hair growth EVERYWHERE.  Maybe I should look for shaver coupons.

This is my cool ass pill organizer I got on Amazon here:  http://www.amazon.com/gp/product/B000E13BVA/ref=oh_details_o03_s00_i00?ie=UTF8&psc=1

EKG Results - Follow Up

Today I had a follow up EKG with Dr. Langhorne.  Dr. Langhorne has been in practice as a cardiologist for 51 years.  He was very grandfatherly -- sweet looking, experienced, gentle.  I actually really liked him after I got over the shock of his age...until he said two things to me:

1. He referred to me as having a "large frame" (TWICE)....in reference to where the EKG stickers are placed, sometimes they are not placed in the exact right places to get a proper EKG.  So basically he admitted it was a technical issue of placement that is further complicated by my fat.
2. The doc asked me if I exercise regularly. (No)  Do I have any trouble walking.  (No)  Do I have any difficulty with taking stairs.  (Not really, unless we're talking more than two flights).  He must've noticed my quizzical expression at all of the questions because he said, "you'll need to do a stress test."...oh gawd, no.  Apparently if I was incapable of walking or stairs, I could've had done the next test chemically, somehow...Damn.  I was so prideful with being able to say that I can walk and do stairs that if I had answered differently, I could remain my lazy self and skip the treadmill altogether.

So my "stress test" is seriously stressing me out -- just another appointment, more tests (he also wants an echocardiogram, which is a sonogram of my heart walls), more sick leave to take that I barely have....more missed work.  And just another hurdle to hopefully get over and get closer to a surgery date.

So all this crap is scheduled for Tuesday, 6 May.  I have to be there at 8 AM and it'll take three hours. I seriously better not be on a damn treadmill most of that time.  Then I get to eat lunch and my echo is at 12:30 PM same day.

BTW, this is Dr. Langhorne.  Hope he's alive long enough to review my results!  ROFLMAO.

I'm going to Hell.

Age 132

EKG Results

Abnormal.

Can't say I'm not worried.....but just a teeny bit.

I'll be going to another appointment soon for a 2nd EKG and if that one is still abnormal, I may have to do a stress test.

I posted on Bariatric Bad Girls Club (it's a Facebook support group) about it and apparently I should have nothing to worry about - abnormal results are common.

Of course I also Googled it right away and if you are not warm enough or still enough, it could skew the results and make them appear abnormal.

Nutritionist Consult #5

Ashton weighed me in since Nurse Jennifer is on vacation this week.  They sent away their main scale to be recalibrated (duh), so I weighed on their back up  -- a Tanita scale.  It read 250.0.  Up 2 pounds since last month.

Two hundred and fifty pounds.  An eighth of a ton.  Halfway to three hundred.  My highest adult weight.  What's funny, if anything can be "funny" about that is that I am not really that upset about it. Because I know my life is going to change very soon.

In approximately 64 days, my journey continues with a permanent, life-long tool.  A tool that if used correctly, will help me shed 50-75% of my excess weight (in my case 50-75 lbs).

Ashton and I talked about how I did on my goals last month and created new ones for this month.  We talked more in depth about vitamins.  One of my goals for this month is to work on my organizational and planning skills for meals and snacks.  Another one is to walk a mile five times a week.

My next appointment is on Thursday, May 15th after work.  The day after will be my final writeup with Ashton, an hour long appointment in the morning where she will go over more in depth about my eating plan during each phase after surgery, as well as a review of all of the good habits I have been practicing that I will need to stick to after surgery.

Ashton told me that once the paperwork is sent to the insurance company, they will take 1-10 business days to respond and hopefully APPROVE me for surgery.  Then and only then will my surgery be scheduled, and that will likely be 2-3 weeks out from the date of approval.

Somewhere between approval and surgery date I will be attending a pre-op class and meet one last time with Dr. G.  I also will have to do a 1-2 week liquid diet (gawd please be only one week).

Another piece of info Ashton confirmed is that Dr. G only does surgeries on Mondays and Tuesdays.  I don't know why but I have the expected surgery date of 6/17 in my head.  I can't explain it, but I just have a feeling.  I'm counting on it, I guess.

When I went to check out, Hope asked if I had a chest x-ray done yet.  I thought I had checked off all the boxes, but I must've missed the chest x-ray, so I got that taken care of today, too.

That is all for now.  Still can't believe how fast time flies.  I'll be on the surgery table before I know it.

That makes me very happy.

My 1st Support Group

Tonight was support group night and Rich accompanied me.  It was pretty cool.

Other than several pre- and post-op attendees, Jennifer the Nurse and Ashton my Nutritionist were there along with a guest, Ryan, who informed us about a new FDA approved B-12 nasal mist called Nascoball.

I also met a girl named Leticia who had the sleeve done two months ago.

Leticia is already 47 lbs. down.

I asked her for her number so I could keep in touch with her between meetings.  And I told her about my favorite Facebook group for bariatric support.

One of the post-op ladies, Laura, told her story.  She works at Navy Fed - I recognized her husband right away.  I found that we had a few similarities which was inspirational.

She said that every day she woke up she was tired.  She was tired all day at work and after work she just crashed on the couch and didn't want to do anything.  Now she is over 120 lbs. down (after a year) and once she decompresses for a little time after work, she's like "what can we do around the house?  lets do some gardening, run errands, etc etc"....so needless to say she has a lot of energy to do things she never felt like doing.

Pretty cool.  I'll head back next month and every month after.

Interesting!

My mom sent me my "school records" book that she kept on me from K-12th grade.

Each page in the book has a bunch of stuff to fill in each year to keep track of my growth and the opposite side of that is a space for a school picture which is also a folder that holds my report cards, awards, and anything else significant.

The reason I wanted it is because every year we recorded my height and weight.  

Tonight I looked up my stats at age 8, 11, 13, and 18 just to see if by general standards, I was in a normal range for my age/height/weight.

At age 8, I had a BMI of 16.9.

At age 11, it was 19.5.

At age 13, it was 21.5.

At age 18, it was 23.5.

At all four ages I was considered in a "healthy range".  It was interesting that it continued to increase rather than staying steady.

Why is it that I always felt chubby my entire childhood?  Even my daddy nicknamed me "Chubbs" at some point as a small girl, but I don't remember feeling bad because of that, I saw it as a term of endearment honestly.

Maybe other school kids made me feel different than everyone else and I just grew to believe it myself.  

Funny to see that when I graduated high school in 1995, I weighed around 155 lbs, which is well within my ideal range that I want to get down to.

Ugh. Feeling Fat.

It sucks carrying this much weight.  I am only a few pounds from my highest weight in my adult life.  Hell...my ENTIRE life and I am feeling every ounce of it.  My wedding rings are too tight -- I can't wear them without discomfort.  My underwear I wear the most is so uncomfortable.  I'm lucky I still have two work pants that I can wear.  I am bored with my closet.  I feel like I'm not good enough to wear all of my gorgeous heels.

I remember when I was down to 202 (Nov 2011 or so).  Feeling sexy even though I still had lots of fat.  I rocked stilettos, had a waistline, was wearing size large tops and 14 bottoms.  I looked forward to planning outfits each morning.  I took time to groom myself, took pride in my appearance.  Loved the attention from people that hadn't seen me in a while.  Then I gained it all back.  Just like the other dozen times I've tried to lose weight and keep it off.

That's why this tool -- my sleeve -- will be a godsend.  I need something to help me -- permanently...for life.   I will have to use it to my advantage -- it won't do all the work for me.  I will be committed.  I will be different.  I will eat well.  I will get all my protein in....I will drink all my water.  I will avoid carbonated drinks, alcohol, and non-nutritious foods for a very long time....I can't say I will never have an Oreo again (I will), but in the beginning, I am going to be the star pupil.  I will surprise myself.  I will be a success story.

If I have calculated correctly, at the latest, my surgery date will be about 17 June or so, and that's being generous.  That's 75 days from today.  Yes, I have a counter on my cell phone.  (I also have a counter for Cape San Blas trip - 17 days, and Ireland - 172 days).

So I am taking it day by day.  Looking forward to getting ONE more appointment behind me.  April 14th can't come fast enough.  May 15th, May 16th, waiting to hear back about insurance approval, getting a surgery date....surgery day....then....then my journey continues.  The hard part.  The best part.  The rest of my life.  Being healthier, feeling better, looking better, living fully, being happy.

That's all I want.